The following is one man’s written reflection on dying. It is worth reflecting on his words to garner a more intimate perspective on ideas of hope and growth when faced with the reality of terminal illness.

Just so you understand: I am dying. I am in the end stage of metastatic prostate cancer, and after six-and-a-half years of close association with the disease, I have another six months to two years to live. That probably sounds exhibitionistic, but I don’t mean it to. Nor am I fish­ing for pity. Truth is, I’d sooner have your laughter.

Man says, “I’ve been diagnosed with terminal cancer, but I am going to fight it with everything I’ve got.” “My money’s on the cancer,” his friend says. Find me that friend.

When it is incurable, as mine is, cancer always wins in the end, but no one—I mean, no one—wants to hear any such thing. The preferred message in our culture is the sentimental one of hope. Hope is not, however, what the terminal cancer patient needs. Even if you believe in miracles, you cannot hope for one—not the way you hope the car’s skid comes to a stop before the cliff’s edge.

“By definition,” C. S. Lewis writes, “miracles must of course inter­rupt the usual course of Nature,” but if they were as common as mosquitoes in summer they wouldn’t be interruptions of the usual.

What cancer patients need more than anything is to take responsibility for their disease. From their doctors, from their family and friends, and especially from themselves, they need simple honesty about their condition, their treatment options, their chances. They require exactly what the psychological theorist Karen Horney said the neurotic requires if he is to grow as a human creature: the “square recognition of his being as he is, without minimizing or exaggerating.”

A cure may not be possible, but even in the face of death, moral and intellectual growth is. Susan Sontag was right, in Illness As Metaphor (1978), to object to the Victorian attitude toward consumption—that it was a narrowing of life to a focus upon what is good. There is nothing good about dying of cancer, especially when, as I do, you have four children under the age of eleven and a wife whom you lust after and adore.

But how then do I account for the fact that, every Shabbes after the Shemoneh Esrei, I feel compelled to thank the Creator of the Universe for my cancer? How do I explain the reaction of Bruce Pearson, the uneducated third-string catcher in Mark Harris’sBang the Drum Slowly (1956) who is diagnosed with Hodg­kins’s lymphoma at a time when it was incurable? “I am doomeded,” Bruce tells his room­mate:

But the world is all rosy. It never looked better. The bad things never looked so little, and the good never looked so big. Food tastes better. Things do not matter too much any more.

Except for the taste of food—chemotherapy makes everything taste metallic, when it does not taste like wet cotton mush—I know what Bruce is saying. The music I listen to, the literature I read when I can barely summon the will to lift a hand, never spoke to me with such finality as it does now.

Is cancer ever a blessing?

No, but only because no human experience, not even marriage, not even the birth of a child, is a sign of God’s favor and a promise of unbroken happiness. Cancer may be a death sentence, but there are many ways to read the sen­tence. Resignation is only one of them, and a particularly arrogant one at that, because it pre­sumes to know, as it cannot, the outcome in every detail.

But if you are ignorant of the suffering that awaits you when you are first diag­nosed, you are equally ignorant of the changes that cancer will work in your thinking and emotional life, some of which may even be improve­ments in old habits of thought and feeling.

You may, for instance, become more conscious of time. What once might have seemed like wastes of time—a solitaire game, a television show you would never have admitted to watching, the idle poking around for useless information—may become unex­pected sources of joy, the low-key celebrations of being alive. The difference is that when you are conscious of choosing how to spend your time, and when you discover that you enjoy your choices, they take on a meaning they could never have had before.

You no longer waste or mark time. You fill it, because now you can see the brim from where you are lying.

“In a sense,” Flannery O’Connor wrote to a friend about the lupus that would kill her at thirty-nine,

sickness is a place, more instructive than a long trip to Europe, and it’s always a place where there’s no company, where nobody can follow. Sickness before death is a very appropriate thing and I think those who don’t have it miss one of God’s mercies.

How could it possibly be merciful of God to reduce you to the hyperawareness, every second of your waking life, that death is relentlessly approaching? Even if it is a knowl­edge that most other men and women do not have, regardless of what they may like to say, is it knowledge worth having?

You find yourself on a distant planet, alone, with only your own inner resources to fall back upon. No amount of magical thinking or denial will alter your circumstances. You either accept what you have become, and rise above yourself to attend to the others who still need your attention, or you spend your last months in the confine­ment of self-pity.

In either case, death will come when it comes. The mercy, perhaps even the good­ness, is in recognizing the gulf that separates life, which may include terminal illness, and death, which is inevitable, but not quite yet. Whatever your condition, you may always choose life, although you may also choose not to. As Hamlet says, “The readiness is all.”

D. G. Myers is a critic and literary historian who taught for nearly a quarter of a century at Texas A&M and Ohio State universities. He is the author of The Elephants Teach and ex-fiction critic for Commentary. He has also written for the New York Times Book Review, the Weekly Standard, Philosophy and Literature, the Sewanee Review, First Things, Jewish Ideas Daily, the Daily Beast, the Barnes & Noble Review, the Journal of the History of Ideas, American Literary History, and other journals.

A challenge of the constant exposure to Social Media is envy. In the article below, the author discusses envy in relation to what we read online on a daily basis and offers a suggestion regarding how to recognize and not allow envy to overwhelm.

The rise of social media makes it easier than ever to open a window onto the lives of others. We watch as our neighbors clink glasses and toast their anniversaries, witness a teenager who lives three states away show off his expensive new car, and scan through baby photos, job promotions, and life events of people we’ve never met. Someone with bragging rights about a recent windfall can reach far more people with news of accomplishments and good fortune than ever before.

Why, then, aren’t we all celebrating?

In a New York Times op-ed titled “The Downside of Inciting Envy,” Arthur Brooks discusses the rise of envy in American culture, focusing on the divide between wealth and poverty and the changes in our collective attitude as that gap widens. Brooks writes, “Unsurprisingly, psychologists have found that envy pushes down life satisfaction and depresses well-being. Envy is positively correlated with depression and neuroticism, and the hostility it breeds may actually make us sick.”

While social media has the potential to make a big world smaller, to bring people of all kinds together, and to strengthen the bonds of friendship, its downside is bleak. Let’s face it: We don’t always experience joyous excitement when scrolling through photos and posts of our friends doing well, enjoying a vacation, or having fun together. Prosperity, pleasure, or an unexpected bonus in someone else’s life can stab you with pain. It might make you depressed or even ill.

Imagine my therapy client who has fertility issues. What does it feel like to her every time she opens Facebook to find a post from yet another former high school classmate announcing her pregnancy? Consider your neighbor who has been unemployed for a year logging onto Google+ only to discover that his longtime friend was recently promoted—again. Sure, there are plenty of people online congratulating one another, sharing in joy, and finding vicarious happiness in the success of others. But envy can be powerful and decidedly unpleasant.

Social media amplifies unintended slights or emotional injuries. Most of all, it exponentially increases the likelihood of social envy.

It’s important to acknowledge the effect this has on us. Envy pops up, sometimes automatically and without our consent. Pushing it down and pretending it doesn’t exist isn’t any healthier than indulging or wallowing in it.

A neuroscientific article about envy and the brain explains that abstract emotions (like envy) are experienced in precisely the same way that concrete feelings (like physical pain) are. The brain doesn’t distinguish between the two. Slam your hand in the car door? It hurts. Experience a surge of envy? Same thing. If envy creates pain, it’s a form of suffering, and it’s important to work toward finding positive, healthy ways of managing it.

The Internet brings us closer to each other and we see more. It’s like living in a big, crowded city. In a big city, residents learn how to move efficiently, how to work with one another as they walk down a busy street, how to form a queue, and how to live together in as much harmony as possible in close quarters. On the Internet, in the big city, and in our own social networks, we must become responsible for managing our unavoidable human emotions in a way that won’t inflict negativity on others or sickness and unhappiness on ourselves.

The first step is recognizing envy as it occurs, noticing when you catch yourself falling into a feeling of chronic comparison and disappointment, and understanding that while those feelings might be natural, they don’t have to linger. You can make choices about the attitude you want to take toward the success of others. You can elect to celebrate with them rather than feel emptiness. You can decide to notice a sense of fullness and gratitude rather than counting up the perceived lacks in your own life. A good start is to accept the initial wave of envy and then move forward toward a more positive mindset, for your own good.

Someone, somewhere, has exactly what you want. The attitude you choose to have toward that fact will have long-lasting implications for your own health.

This article first appeared on Rewire Me. To view the original article click here. Pamela Milam is a therapist and life coach who lives in Dallas and New York. She is the author of Premarital Counseling for Gays and Lesbians and is working on another book that takes a close look at what happens inside the therapy office.

Ten years after she began organizing chaplaincy programs in Israel, Cecille Asekoff is seeing her dream come true.

During a 10-day visit to Jerusalem that ended on May 22 Asekoff saw the fruits of her efforts, as executive vice president of the National Association of Jewish Chaplains, to professionalize the ranks of those who minister to the sick, the elderly, and the dying in Israel.

There are now 23 professional spiritual caregivers certified who work in health-care facilities in many parts of the country, “and another dozen or so are in the pipeline,” said Asekoff at an interview in her office on the Aidekman campus in Whippany. “People are receiving pastoral care in every nook and cranny in Israel, and there are more and more of them every day.”

With financial aid from such sources as the Jewish Federation of Greater MetroWest NJ, UJA-Federation of New York, and the American Jewish Joint Distribution Committee, training programs for professional spiritual and pastoral caregivers are expanding in many parts of Israel.

Asekoff, who also serves as director of the Joint Chaplaincy Committee of Greater MetroWest, has been visiting Israel to set up and oversee training programs in many parts of the country for nearly a decade.

The committee and the NAJC, she said, “absolutely” helped make the programs in Israel a success. The training “is not just reading books and writing book reports,” said Asekoff. “It is clinical supervision. It is individual supervision. It is group supervision. It is a spiritual assessment that the trainees conduct on themselves.”

Asekoff acknowledged that at this point only Jews have applied for the training.

“But part of what it means to be a professional chaplain is that you can provide spiritual and pastoral care on a multi-faith level,” she said. “We have a responsibility to train people of various faiths, including Muslims and Christians. We are reaching out to non-Jews on official and non-official levels,” she said, “but to date no one who is not Jewish has signed up for the professional training.”

Those who are being trained, however, are making inroads beyond Israel’s Jews. At Rambam Hospital in Haifa, for example, 50 percent of the patients are not Jewish, said Asekoff. In addition, the Jewish chaplaincy service is part of an international multi-faith committee that accredits programs in the United States and Europe and is working now to adjust their accreditation standards to Israeli culture.

In contrast to America and Europe, Israelis being trained in the field of spiritual and pastoral care are “coming out of the non-clerical world,” she said. “Spiritual care is not necessarily religious, but we do insist that Jewish chaplains have grounding in Jewish literature and Jewish ritual.”

Currently, the chaplaincy training program gets no support from the Israeli government. The hospitals receive government funds, but none specifically allocated to spiritual care providers.

“I’d like to see the field recognized by the government and included in the budget lines of health-care facilities,” Asekoff said. “We have to go and lobby the Knesset and have our message published in the newspapers.”

She remains optimistic.

“I believe professional spiritual and pastoral care chaplaincy is the one thread that can unite all of us with our different ideas, with our different beliefs, with our different colors and sizes. Something we all share together is walking through life and entering people’s lives at critical moments and being able to service them and make their journey more palatable.”

I received this article by email the other day. It describes one physician’s take on the issue of DNR in relation to a physician’s own ethics. The author questions why doctors would not advice patients the same as they would act themselves when faced with the same discussion of choosing aggressive treatment over allowing natural death. I find his honesty refreshing. I find that his commentary actually revolves around a greater ethical problem, the issue of autonomy over paternalism. It is almost as if many physicians want to avoid the instinct to instruct so much that they tell patients things they would never really want to advise in the first place.

In the event that I suffer from a terminal illness, once the point has been passed where a return to health or meaningful quality of life is no longer a realistic possibility, when further treatment will do nothing but fill my days with more of itself, then I want that treatment to end. Though I hope such plans are a long, long way from ever being enacted, my husband and other loved ones know that I would not want “heroic” measures to prolong my life, and would choose a peaceful rather than a protracted death.

I am not alone in this. A new study in the online journal PLOS One reports that most of my fellow physicians feel the same way. The authors of the study surveyed over a thousand doctors, and just over 88 percent of them reported wanting an advance directive that would stipulate “do not resuscitate” (or DNR) status at the ends of their lives. I would have answered precisely the same way.

Those results do not surprise me in the least.

I cannot imagine going all the way through medical school, to say nothing of residency, without witnessing cases where patients received medical care that prolonged their existences but not their lives. It is a common enough occurrence that I would generalize it to essentially every graduate of medical school. We’ve all seen patients given interventions that preserved the functioning of their organs without any hope that the people themselves would have anything but misery to number out their days.

Why is this so? Why does the same study report that doctors will often override an advance directive if it conflicts with their clinical decisions that further treatment is warranted? Why would we order medical care that we do not want for ourselves?

At io9, George Dvorsky mentions the cynical possibility that physicians might do this for the sake of charging for lucrative end-of-life treatments. In the Pulitzer Prize-winning play Wit the central character is subjected to prolonged end-of-life interventions because her doctors care more about their medical studies than about her. I would love to believe that this never really happens, that members of my profession put the wishes and well being of their patients before any other considerations, but I would be a fool to be so naive. Sadly, even the mother of a close friend of mine was treated in this manner. I am sure that this happens, as loathsome as I know it to be.

However, I do not believe that most physicians opt for extensive treatments for their dying patients for this kind of reason. I suspect that for most of us, it’s due to a more complicated and less appalling set of considerations.

First of all, prolonging and supporting patients’ health and life is the entire reason for taking care of them in the first place. With the limited exception of medical providers who specialize in palliative care, we strive for our patients to recover, to leave our practices and clinics cured, or (failing that) well enough to have a baseline quality of life that justifies our being involved in their care in the first place. Letting go of this cardinal goal can be immensely difficult. If we can’t make people better, then what exactly is it that we’re accomplishing?

Further, there is always the fear of being accused of not doing all we could. The more we treat a patient, the less ambiguous our attempts to give them the best care possible. What better defense can there be against the threat of legal action than a full-court press at the very end? Though it’s a difficult factor to quantify, I suspect this kind of rationale undergirds a lot more of the aggressive end-of-life care that patients receive than many medical providers would care to acknowledge.

There seems to be little space for any kind of nuanced or challenging conversation along these lines in our society at this time. One need look back no further than 2009 and the blight on our political discourse that comprised the “death panels” discussion, in which quondam vice-presidential aspirant Sarah Palin proclaimed that the Affordable Care Act would empower faceless bureaucrats with the authority to pull the plug on grandma.

Deemed the “Lie of the Year” by PolitiFact, what the law would have done (before the specific provision was stripped) was compensate doctors for appointments where they actually talked with patients about their wishes for end-of-life care. Thanks to the former governor of Alaska, physicians who choose to sit down with people and hear what they would want if they were dying cannot get paid for doing so.

But really, this kind of conversation is hard for doctors in general. We are not nearly as good as we ought to be at talking about the reality that even the best we can offer won’t fix everything, and that everyone eventually dies of something. In modern medicine, every death is a defeat, and every illness is merely a chance to prove our worth as diagnosticians and healers.

As a pediatrician, I am generally spared this kind of conversation. Almost all of my patients are basically healthy. But even when I had a chronically ill patient who had a DNR order and was showing signs that he might be dying, I made sure to mention that more aggressive treatment was available should the mother opt to choose it, though I certainly did not push for it.

Watching a patient die without trying to stop it is not only contrary to our impulse to fix things, but it is obviously an irrevocable clinical decision. I can understand all too well how members of my profession would be terrible at making it.

And yet we must do better. We cannot routinely deliver medical treatments that we would not want for ourselves if patients have made the same decisions we would. I would want my loved ones to advocate fiercely on my behalf to have my end-of-life wishes honored, and we must improve our ability to honor similar wishes when they come from people who have entrusted their care to us. Dying patients are among the most vulnerable that we will encounter in our careers, and our duty to minimize suffering we would spare ourselves is a sacred one.